The Dark Side of Fitness

Inside the often unfortunate, sometimes weird, and occasionally gruesome drawbacks of fitness fanaticism.

April 2016

—Photography by Tom Speruto

Because rest can become a four-letter word.

It’s no secret that those who gravitate toward endurance sports tend to be aggressively type A and atypically driven to succeed. Those personality traits are perhaps partly responsible for one-time recreational athletes morphing into elite endurance racers. But they’re also probably responsible for a lot of sports-related injuries. Sarah Bay, 36, an Aurora-born marathoner and triathlete, says she’d take the “probably” out of that sentence.

In 2003, a friend talked Bay into doing the Big Sur Marathon. The pretty, petite blonde admits she didn’t train much for that race, but she competed so well she qualified for the Boston Marathon. She was hooked. “That race started my running craze,” Bay says. “I ran waaaay too many marathons in 2004.” 

In those days, Bay says, she had no idea what rest and recovery were. “For me, it was always train more, more, more,” she says. “I didn’t know taking a day off was good for my body.” The result? Catastrophic injuries. In February 2005, she sustained a stress fracture to her left heel. Eight weeks later, she started running again—too fast, too much, too soon—and got plantar fasciitis in her right foot. To battle the pain so she could continue to run, Bay got cortisone shots in her right foot—and promptly tore her plantar tendon. Throughout that summer she continued to run, despite knowing her feet were in a state of distress. When she finally got an MRI in September, the images showed absolute devastation: bone edema, soft-tissue swelling, stress fractures, and a complete rupture of the plantar fascia. Translation: Bay’s feet were wrecked.

That didn’t stop her from running a marathon in October—before she forced herself to stop for nearly two years. “It was awful,” Bay says, “and stupid.” That may be the case, but it’s not uncommon. “World-class athletes take days off,” says the University of Colorado Sports Medicine and Performance Center’s Dr. Iñigo San Millán. “In fact, world-class athletes sometimes take weeks off. These folks in Colorado, they don’t. They are skipping the recovery phase.” Recovery, according to San Millán, allows microtears in muscles and tendons to repair themselves. It allows hormones—like cortisol and testosterone and estrogen and others—to rebalance. “The body takes a breath,” San Millán says. “And that’s critically important.”

Today, Bay has fully transitioned from marathons to triathlons, and she takes days off (albeit begrudgingly). She’s also hired a coach and spends four to five hours each week at Denver Sports Recovery trying to take better care of her body. “When I started training, I had no idea how much sleep I needed or how to fuel my body appropriately,” Bay says. “I mean, I was eating Lean Cuisines and running every day. It was not a great training plan.”

Because you’re probably going to hurt yourself. 

Local orthopedic surgeons Dr. Andrew Parker and Dr. Michelle Wolcott, as well as primary care sports medicine specialist Dr. John Hill, break down some of the more common ailments that limp into their offices.


Anterior knee pain: usually related to stress or overuse or incorrect form when lifting

Achilles tendonitis: inflammation in the tendon caused by overuse

Rotator cuff tendonitis: caused by lifting too much weight above the head or using incorrect form when lifting

Lower back pain: usually related to strain from lifting too much weight or not correctly balancing when lifting


Anterior knee pain: sometimes attributed to weak glutes and inwardly rotated thigh bones (although the cause could be due to a variety of factors)

Plantar fasciitis: inflammation and tears in the plantar fascia near the heel caused by too much stress on the heel

Shin splints: sometimes caused by too-long strides

Stress fractures in legs, feet, and hips: often caused by low bone density, overuse, weak muscles, or doing too much too quickly

Meniscus tears: typically caused by an acute twisting or bending of the knee

Achilles tendon injuries: sometimes aggravated  by speed training, running uphill, or landing on the forefoot.


Acute injuries from crashes: frequently, head injuries and broken clavicles and upper extremities

Numbness in hands: nerve compression often triggered by putting too much weight on the wrists while riding

Neck and lower back pain: tightness in the trapezius muscle usually attributed to riding with a curved back

IT band syndrome: caused by friction of the connective tissue between the quad and the hamstring, which can happen when the knees are pointing too far in or out

Achilles tendonitis: inflammation in the tendon caused by overuse or because a rider’s calf muscles are too tense (sometimes remedied by moving cleat position)

Patellar tendonitis: caused by fatigued adductor muscles, which can be related to bike fit or an athlete’s unique hip rotation


Rotator cuff injuries: usually attributed to overuse or weak shoulder blades or back muscles

Bicep tendonitis: often caused by overuse or by hunching forward while biking

Nutritional deficiencies: usually ascribed to insufficient caloric intake for the amount of fuel burned while swimming, cycling, and running

Lower back pain: experts sometimes blame a limited range of motion in the hips or bad posture when running or cycling

Because when you said “I do” you thought your penchant for endurance sports was covered in the “in sickness and in health” section.

Max and Andrea Fulton have been together for 19 years. He’s handsome with a slightly crooked smile; she’s beautiful in the way only natural redheads can be. They’re sitting next to each other on the opposite side of the booth from me at Benny’s Restaurant and Tequila Bar in Cap Hill. They clearly love each other; their gentle teasing gives it away. But because I’ve asked them to tell me how Max’s proclivity for endurance sports affects their marriage and family, they’re not quite as sure about me.

Andrea warms up pretty quickly, though. “Max lives his life as close to death as possible,” she says with a laugh. “Unfortunately, I’m the most risk-averse person I know.” She isn’t totally joking about the 39-year-old father of her two young children. Max has completed more than 130 endurance events—marathons, triathlons, ultramarathons, road-cycling races—in the past 17 years. In summer 2015, he completed the Ironman Boulder, the Leadman series, and Run Rabbit Run 100—about 450 miles of racing total—in approximately three months. Oh, and he ran the Boston Marathon in 3:06 that year, too. When I ask him why, Max says, “Being in shape is nice, and I’m really competitive, and, well, I want to find out what my limit is. I don’t get pushed to my limit during everyday activities.”

I look at Andrea and ask if she’s ever reached her limit—with all the training and racing and resulting injuries, including stress fractures and a broken collarbone. “It’s sometimes challenging for me that Max has so many passions,” she says. “I struggle with the fact that I don’t really have that many.” I suggest it might be difficult for her to find the time for such leisure pursuits with kids and her job at the Denver Art Museum and Max’s long list of athletic addictions. “Sometimes I get resentful that he gets to take that time,” she says, explaining it was more challenging when their kids were babies than it is now. “But he’s grateful for it, which really helps. Plus, I get a lot of flower arrangements in August, which is always a brutal month [full of endurance events].”

The Fultons try to limit the potential for disagreements about training and racing when they can. It’s a savvy move considering how frequently experts like sports psychologist Doug Jowdy, Ph.D., see what’s colloquially referred to as “divorce by triathlon.” “It’s not uncommon that athletes can become more passionate about their chosen sports than about their spouses,” Jowdy says. Fortunately, that’s not the case with the Fultons—probably because they work so hard to make sure it isn’t. For example, Max gets up early—like 5 a.m. early—on weekdays to get in his training so it doesn’t interfere with the rest of the family’s day. When Max has a race out of town, the Fultons try to make it a family affair, something that can be enjoyable for Andrea and the kids as well as for Max. And when endurance event season is over, there’s a moratorium on talking about it or planning for the next season—at least for a few weeks. “Our biggest challenge with this has always been time,” Max says. “It’s our most valuable resource. Andrea does get her time, but it’s less than mine. It’s something we work on.”